Week 1 ENT 2 of 4 Flashcards Preview

SUM '20 - Health Assessment > Week 1 ENT 2 of 4 > Flashcards

Flashcards in Week 1 ENT 2 of 4 Deck (26)
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1

Risk related to undiagnosed Ear disorders?

•Poor language development

•Delayed learning

•Social isolation

•Hearing loss

•Risk for falls

•Missed diagnoses of respiratory and oral infections

2

Types of and causes of hearing loss:

•Conductive

–Poor transmission of sound waves through the external and/or middle ear

•Sensorineural

–Diseases of the cochlea and/or poor conduction of sound-generated impulses along the eighth cranial nerve to the brain stem

•Mixed

–Combination of both conductive and sensorineural hearing loss in the same ear

3

Types of hearing scuity test?

•Tuning Fork Tests

–Test the ability of the patients to hear pure tones

–Weber Test

–Tests for adequacy of bone conduction

–Rinne Test

–Tests for comparison of air conduction to bone conduction in each ear separately

•Whisper Test

–Gross screening test for hearing acuity

4

•More than 75% of all children experience at least one episode of ______ before the age of 3 years

•More than 75% of all children experience at least one episode of otitis media before the age of 3 years

5

•Allow young children to_________.

•Allow young children to sit in their parent’s lap

6

Consideration for Ped patient:

•Allow young children to sit in their parent’s lap

•Make a “game” of the examination to gain cooperation

•Get acquainted with both the child and the parent prior to the examination

•Explain the examination

•Allow the child to become acquainted with the equipment

7

Consideration for Adult patient:

•30% to 40% of adults over age 65 years experience some degree of presbycusis

•There is an increasing incidence of tinnitus until about 70 years of age

•Vertigo increases with age

•A common cause of hearing loss is cerumen impaction

•Hearing loss may be associated with paranoia and agitation

•Men have poorer hearing after age 40 than women

8

Paranasal sinuses and their locations:

•Maxillary sinuses

–Below the orbit of the eye in the maxillary bone

•Frontal sinuses

–Frontal bone just above the eyebrows

•Ethmoidal sinuses

–Ethmoid bone lying behind the eyes and nose

•Sphenoidal sinuses

–Sphenoid bone behind the eyes and the nose

9

Types of bleeding and possible causes:

•Copious and short-term bleeding

–Associated with trauma

–Usually an isolated incident

•Chronic bleeding

–Drug therapies

–Chemotherapies

–Very dry environment and fragile nasal mucosa

10

What instrument do you use for examination of the interior nasal  cavity?

•Use an otoscope with cover to examine the interior nasal cavity

•Individuals are sensitive to the examination of the nose

11

How do you palapte and percuss the nose?

•Palpate the bridge and soft tissues of the nose

•Palpate the sinuses

•Percuss the sinuses

•If tenderness is noted, transilluminate the sinuses to gather additional information

12

Focus of past medical hx?

•Allergies

•Influenza and colds

•Chronic respiratory problems

–Polyps

–Sinusitis

–Septal deviation or surgeries

13

Common disorders of the nasal system?

•Congestion

•Epistaxis

•Trauma

•Rhinitis

•Sinusitis

•Smell and Taste Disorders

•Tumors and polyps of the nose

14

Congestion is?

•Vascular changes in the nasal mucosa caused by neural, hormonal, or local mediators

15

Subjective findings of congestion?

•Subjective findings:

•Rhinorrhea, coughing, sneezing, purulent discharge, fever, eye symptoms

16

Objective findings of congestion

•Objective findings:

•Erythema of the mucosa, pallor, edema, atrophy, crusting and discharge

17

Management of congestion?

•Management:

•Topical decongestants or inhaled corticosteriods such as nasocort, nasonex, etc work better than over-the-counter oral agents. Nasal lavage and saline nasal sprays can be beneficial

18

Health promotion of congestion?

•Health Promotion:

•Over-the-counter medications containing pseudoephedrine and phenyleprhine should be used with caution.

19

What is epistaxis?

•Bleeding from the nose from irritation, trauma, infection, or tumors.

20

Subjective an objective findings in epistaxis?

•Subjective findings:

•May be acute or chronic

•Objective findings:

•Scant to copious amounts of bleeding from nares

21

Management of epistaxis?

•Management:

•Leaning forward while applying direct pressure to the anterior portion x 15 minutes, topical decongestants such as phenylephrine (vasoconstrictors) are helpful, cauterization may be necessary for persistent bleeding, nasal tampon with bactroban lubrication x 48 -72 hours.

22

Health promotion of epistaxis?

•Health Promotion:

•No picking in nares, avoid anti-coagulants several days, avoidance of spicy foods and tobacco (vasodilators)

23

What is a trauma to the nose?

Follows direct blow to the face from trauma such as MVA, sports injuries, or altercations.

24

Subjective and Objective findings in trauma to nose?

•Subjective findings:

•Ask for mechanism of injury, facial numbness, diplopia, visual changes and bleeding

•Objective findings:

•Periorbital ecchymosis, edema, abrasions, lacerations, epistaxis, trauma to other facial structures

25

Management and health promotion of trauma to nose?

•Management:

•Cool, local pressure to the area, facial x-rays and CT scans to determine precise injury

•Health Promotion:

•Encourage patients to wear protective gear.

26